OS 3 Midterm

Question 1

What bony anatomical structure has a direct relationship with the confluens -> transverse sinus -> sigmoid sinus -> internal jugular vein venous drainage system in the skull?

Answer 1

The occipitomastoid suture has direct relationship with the jugular foramen and is involved in venous congestion

Question 2

What are the 5 basic tenets of the classical cranial model?

Answer 2

a. Inherent motility of the CNS
B. Plasticity, and elasticity of the intracranial and intraspinal membranes
C. Fluctuation of the CSF
D. Articular mobility and involuntary motion of the cranial bones
E. Articular mobility and involuntary motion of the sacrum between the ilia

Question 3

What was sutherlands interpretation of the PRM? This PRM is made up of the CSF, brain/spinal cord, intracranial and intraspinal membranes, and articular mechanism of the cranial bones.

Answer 3

These components form the biophysical structures of the PRM, and they determine the interaction between the volume and pressure of the liquid media of the cranium -> blood and CSF

Question 4

According to Sutherland, in terms of the dynamic relations of the PRM, what controls bone mobility?

Answer 4

Bone mobility is related to and controlled by the reciprocal tension membrane (cranial and spinal dura, falx cerebri and cerebelli, tentorium)

Question 5

What is the modern interpretation of the functioning of the PRM?

Answer 5

Slow, periodic fluctuations in blood volume and csf pressure, supports metabolic, water supply.

• resp for motion of the brain tissue and skull bones
• fluctuations are functionally connected to to chemical and physical homeostatic mechanisms of brain tissue

Question 6

What is the typical range of CRI in living individuals?

Answer 6

6-14

Question 7

How does the shape of the head change with regards to cranial flexion and extension?

Answer 7

Flexion head -> gets wider in transverse diameter and shorter in the AP diameter (stewie)

Extension head -> gets wider in AP diameter and shorter in transverse diameter (brian)

Question 8

What was the general focus and findings of Moskalenkos studies?
What is the intracranial origin of bioimpedance related to?

Answer 8

Found continuous changes in cranial dimensions (frontal and sagittal sections) w/ biphasic characteristics using bioimpedance matching

• decribed cranial volume changes and found rate of 6-14 cycles per minute
• describes interaction between intracranial hemodynamics and CSF circulation
• intracranial origin of bioimpedance related to blood supply and oxygen consumption of cerebral tissue

Question 9

What did Ken Nelson correlate highly with the CRI. How did he achieve these results (techniques)

What did Thomas Crow do research upon?

Answer 9

Traube-Hering-Meyer oscillations. Used doppler flowmetry tom determine this.

Crow looked at healthy humans using MRI imagery to show stat significant cranial bone dimensions

Question 10

Pterion
Asterion
Bregma
Lambda

Answer 10

Pterion is frontal, sphenoid, parietal, temporal bones
Asterion is the parietal, occipital and temporal bones
Bregma is the joining of the coronal and sagittal sutures
Lambda is the joining of the lamboid suture and sagittal suture

Question 11

Main cranial sutures discussed in class

Answer 11

Lambdoid is in the back

Sagittal, coronal, squamous

Question 12

What is the only bone that contacts all 4 fontanelles?

Answer 12

Parietal bone

Question 13

What is the significance in the bevel change midway between the sagittal and lambdoid sutures in the parietal bone?

Answer 13

Creates a hinge that allows motion in the coronal plane about the AP axis

Question 14

What components of parietal bone SD are involved in tension headaches?
Temporal headaches?
What organ/anatomical structure is involved in parietal bone SD?

Answer 14

OM and asterion are involved in tension headaches
Pterion is involved in temporal headaches
MMA -> can be involved in trauma, giant cell arteritis (mri for dx)

Question 15

What is most common form of synostosis? How is the growth restricted?

Answer 15

Sagittal synostosis

Restricted transverse growth of the skull

Question 16

What drives temporal bone motion through the OM articulation?

Answer 16

The occiput

Question 17

What moves the frontal bone during external rotation?

Answer 17

The sphenoid moves the frontal during external rotation

Question 18

What can cause tension headaches w/ regards to mechanical dysfunction of the frontal bone?

Answer 18

Pain along the coronal suture involved w/ frontal bone

Question 19

What can the frontal bone increase tension on that will result in head pain?

Answer 19

Pain from diminished primary respiration and CSF flow due to increased dural tension at the cribiform plate

Question 20

What organ/nerve/muscle dysfunction is associated with the frontal bone?

Answer 20

Sinusitis, visual problems (double vision), anosmia due to influences on cribiform plate, frontalis muscle

Question 21

What would you see in a patient with bicoronal synostosis?

Answer 21

Impaired growth of anterior fossa, skull would be wider than normal and could show turricephaly, which is compensatory vertical growth

Question 22

What does unicoronal synostosis cause?
What will the affected forehead look like?
What is the characteristic appearance of the face that is used for diagnosis?
What must you differentiate this from?

Answer 22

Unicoronal synostosis causes anterior plagiocephaly.
Affected forehead is flat on the ipsilateral side of the fusion and the affected side ear is more forward. The contralateral forehead is more forward.
C shaped facial deformity, the base of the nose is drawn towards the affected side, and the tip of the nose points away. Important for differentiating this from positional/deformational plagiocephaly which is not caused by synostosis

Question 23

What are the fontanelles that the parietal bone contacts?
What bones does the parietal bone contact?
How does parietal move during SBS flexion/external rotation?
What is axis and plane of motion?
Clinical associations?

Answer 23

4 fontanelles (anterior, posterior, sphenoid, mastoid)
5 other bones (frontal, temporal, occipital, sphenoid, parietal)
During SBS flexion/external rotation -> inferior border moves laterally, superior border moves medially and inferiorly to increase R/L diameter
This motion occurs through an AP axis in coronal plane of motion
Clinical ass: synostosis, OM and asterion in tension headaches, pterion in temporal headaches
MMA in trauma, giant cell arteritis, head face and tooth pain

Question 24

What anatomical structures are associated with the petrous portion of the temporal bone?

Answer 24

Eustacian tube -> IR of the temporal bone and result in compression and a HIGH PITCHED tinnitus
Otovestibular organ
Border of foramen lacerum -> gr. Superficial petrosal nerve and ptergopalatine ganglion
Attachment of tentorium
Encloses ICA
Lateral part of jugular foramen
Styloid process

Question 25

What bones does the frontal bone articulate with?

Answer 25

Parietals
Sphenoid
Ethmoid
Lacrimals
Maxillae
Nasals
Zygoma

Question 26

What is the definition of manipulation? (2)

Answer 26

Skillful or dextrous treatment by the hands.

The use of the hands in a patient management process using instructions and maneuvers to achieve maximum painless, movement of the musculoskeletal system postural balance

Question 27

What are the 5 models of osteopathic treatment?

Answer 27

Postural/structural
Neurological
Respiratory Circulatory
Bioenergy
Psychosocial

Organ system as a 6th